For Small-Town Tennessee Judge, Opioid Crisis is Personal

DANDRIDGE, Tenn. — Judge Duane Slone has observed the arc of the opioid crisis firsthand since painkiller addiction began taking ahold of lives in the rural northeast Tennessee counties he serves.

Serving as a drug prosecutor in the 1990s before becoming circuit judge in 2009, Slone routinely jailed addicts who committed petty crimes to support their habits, including pregnant women. "How in the world could someone who has a child in her be addicted to drugs?” he remembers thinking.

But as the number of addicted people grew to include some he had known all his life in Jefferson County, where his hometown has a population of just over 2,000 people, the crisis grew personal.

Then when a family friend asked Slone and his wife in 2011 to adopt a baby born with withdrawal symptoms, the crisis reached his home. He and his wife, Gretchen, watched as the 6-month-old boy struggled with night terrors, ADHD, violent outbursts — lingering effects of his birth mother’s drug abuse.

“When Joseph came to us, I knew about addiction and I knew about neonatal abstinence syndrome, but I wasn’t really dialed in,” he said. “It changed my perspective completely.”

Slone shifted his approach to justice; at times, his methods are controversial.

When any pregnant woman on probation fails a routine drug test, regardless of her initial crime, officers must report it immediately to Slone.

If they don't have a prescription for the drug, the women are immediately sent to a county jail to detox in often uncomfortable surroundings, a process Slone acknowledges is painful for mothers and distressing to fetuses. It also is contrary to recommendations by obstetrician groups and the national guidelines for drug courts.

Female inmates in county jails are offered a free trip to get long-acting reversible contraceptives — such as intrauterine devices, or IUDs — at local health clinics.

Nearly 70 percent of all babies born addicted in the state are in East Tennessee. Slone said his community can't wait for public policy officials to debate the best practices to prevent babies being born with neonatal abstinence syndrome or for the government to send help.

“If I don’t intervene, then both the mom and fetus could be dead before the child is even born,” he said.

Terrence Walton, a longtime addiction treatment specialist, said national drug court officials discourage any practice that would put a woman in jail and not in treatment.

Local civil liberties and reproductive rights groups have questioned whether jailed women may feel coerced by the offer of long-term contraceptives.

Circuit Judge Duane Slone reaches to pick up 1-year-old Gabriel from his mother, Margo Azbill, 37, during her court visit Thursday, Jan. 19, 2017, in Dandridge, Tenn. Azbill has been in recovery court and clean for 16 months after using opioids for 22 years. (Photo: Lacy Atkins / The Tennessean)